사회경제적 취약계층의 건강불평등 해소를 위한 지역사회 건강증진사업 평가

Abstract

Objectives: This study was to evaluate effectiveness of and challenges to community interventions to reduce health inequity in socioeconomically vulnerable populations. Methods: A total of 41 participants involved in community interventions related to a slum of Seoul were recruited using purposive and snowball sampling methods from June to September, 2015. Participants included residents and stakeholders working for governments, public hospitals, welfare institutions, civil societies, and faith-based organizations. We conducted semi-structured, one-on-one interviews with 18 stakeholders and three focus group interviews with 23 residents. Qualitative data were analyzed using thematic analysis. Results: Effective community interventions were community-driven, empowerment-based interventions followed by provision of home-visiting nurses, improvement of living conditions, and integrated health-social welfare services. Affordable health care services, including home-visits by community nurses and increase in housing quality and neighborhood safety were identified as important factors to address to reduce health inequalities. Challenges to community interventions are as follows: (1) unmet healthcare and social welfare needs, (2) insufficient livelihood welfare system, (3) lack of intersectoral collaboration. Conclusions: Community-driven, empowerment-based interventions and supportive social health policies could have the potential to improve health inequities, thereby enhancing community resilience and providing a seamless safety net for the socioeconomically vulnerable populations.